Having a slightly large waist, borderline blood pressure or blood sugar that’s a little high may not seem alarming on its own. But when several of these risk factors show up together, they add up to something more serious: metabolic syndrome. It’s estimated that about 1 in 3 U.S. adults has it.

Metabolic syndrome greatly increases the risk of heart disease, stroke and type 2 diabetes. The encouraging news is that the same healthy changes can improve every one of the risk factors at once.

The five risk factors

Metabolic syndrome is usually diagnosed when someone has three or more of the following:

1. Large waist: 40 inches or more for men, 35 inches or more for women (lower cutoffs may apply for some ethnic groups).
2. High triglycerides: 150 mg/dL or higher, or taking medicine for high triglycerides.
3. Low HDL cholesterol: less than 40 mg/dL for men or less than 50 mg/dL for women.
4. High blood pressure: 130/85 or higher, or taking blood pressure medicine.
5. High fasting blood sugar: 100 mg/dL or higher, or taking medicine for high blood sugar.

Why it happens

Metabolic syndrome is closely linked to excess fat around the abdomen and to insulin resistance, a condition in which the body doesn’t respond well to insulin. Physical inactivity, an unhealthy diet, aging, genetics and certain medicines can all play a role. People with metabolic syndrome are also more likely to have fatty liver disease.

How it’s diagnosed

Your doctor can check for metabolic syndrome with a waist measurement, a blood pressure check and blood tests for cholesterol, triglycerides and blood sugar. Many people learn they have it during a routine checkup.

How to reverse it

• Move more. Aim for at least 150 minutes of moderate activity a week. Even without weight loss, exercise improves blood pressure, blood sugar and triglycerides.
• Lose a modest amount of weight. Losing 5% to 10% of your body weight can improve all five risk factors.
• Eat a heart-healthy diet such as the Mediterranean diet, rich in vegetables, fruits, whole grains, beans, fish and healthy fats.
• Cut back on sugary drinks, refined carbs and alcohol, which raise triglycerides and blood sugar.
• Quit smoking.
• Treat individual risk factors with medicine when needed.

What this means for you

Ask your doctor whether you have any of the five risk factors and how many. Know your numbers, including your waist size, blood pressure, cholesterol and blood sugar. If you have prediabetes, see our guide to turning prediabetes around.

The bottom line

Metabolic syndrome is a cluster of risk factors, including a large waist, high triglycerides, low HDL, high blood pressure and high blood sugar, that together raise the risk of heart disease and diabetes. Regular activity, modest weight loss and a healthy diet can improve them all.

Common questions

How do I measure my waist correctly?

Stand and place a tape measure around your bare abdomen just above your hip bones. Keep it snug but not tight, and measure after breathing out.

Can thin people have metabolic syndrome?

Yes. Although it’s more common with excess weight, people with a normal weight can still have several risk factors, especially if they carry fat around the abdomen.

Is metabolic syndrome the same as prediabetes?

No. High fasting blood sugar is one of the five criteria for metabolic syndrome, but metabolic syndrome also includes waist size, blood pressure, triglycerides and HDL cholesterol.

This article is for general information and isn’t medical advice. Talk with your healthcare provider about your individual needs.

Sources

• CDC: Prediabetes, Could It Be You?
• American Heart Association: What Your Cholesterol Levels Mean
• American Heart Association: Understanding Blood Pressure Readings